VP Pharmacy

VP, Pharmacy Benefits

Provides executive leadership, strategic direction, and decision making for Program wide Pharmacy Benefits Plan including Medicare Part D, Commercial Benefits, Self-Funding, Exchanges, and Medicaid. Responsible for Pharmacy Benefit Management (PBM) Vendor Management, Pharmacy Service Center, and National Pharmacy Fee Schedule. Positions pharmacy as a growth enabler and market differentiator by delivering integrated benefit solutions that support acquisition, retention, and enterprise brand value. Lead strategist for development and management of pharmacy benefit offerings that meet customer requirements, maintain an appropriate risk pool, promote quality, and achieve financial targets. Provides leadership and oversight to program wide Pharmacy Benefit Community of Practice. Serves as program wide Pharmacy Leader for Medicare Part D Drug Benefit. Manages program wide Pharmacy Benefit Management functions including PBM contracts, network management, customer service, benefit design, utilization management and reporting across all lines of business (Medicare, Medicaid, individual, ACA, self-funded, and commercial). Provides leadership and oversight to the National Pharmacy Fee Schedule for outpatient, clinic, and inpatient medications. Collaborates with Health Plan Product Development, Sales, and Marketing to ensure alignment with KFHP benefits, marketing strategies and sales tactics. Collaborates with Regional Pharmacy Leadership in the management of drug benefits in KP-owned and operated pharmacies. Provides program wide consultation and expertise in the identification, dissemination and implementation of drug benefit best practices and opportunities. Assists the SVP, Chief Pharmacy Officer of National Pharmacy in the development and execution of a national strategy for the delivery of pharmaceutical care across the program. Builds strong collaborative relationships with National Pharmacy Service Line Leaders and other Pharmacy Market Leaders of the program to ensure alignment of resources and efficiency of operations.

Collaborates with peers within the National Pharmacy Leadership Executive Team to ensure optimal delivery of pharmaceutical care and implementation of best practices.

Essential Responsibilities

Executive Leadership & Strategy

• Provides executive leadership and oversight to over 80 departmental staff including pharmacists, benefit analysts, information technology, and finance personnel to meet internal and external customer needs.
• Expected to lead, serve, and participate on various committees at the senior leadership level.
• Assures appropriate design and execution of the pharmacy benefits plan to meet operational, clinical, regulatory, and financial objectives, in primary collaboration with pharmacy executives.
• Plays a key role in aligning pharmacy strategy with market growth, enterprise performance goals, and health plan product development.
• Defines and leads governance structures for pharmacy benefit decision-making-ensuring transparency, shared accountability, and alignment with enterprise priorities.
• Leads through influence in a highly matrixed environment-navigating market variability, aligning diverse stakeholders, and building consensus for transformative change.
• Champions the voice of the customer (members, purchasers, and brokers) to ensure pharmacy benefits meet evolving expectations and drive satisfaction, retention, and sales.
• Serves as executive pharmacy sponsor or co-sponsor for health plan initiatives and projects impacting pharmacy.
• Provides strategic support for applicable pharmacy initiatives with Risant.

Pharmacy Benefit Design & Management

Market Analysis & Customer Experience

Financial Oversight & Vendor Management

Regulatory & Compliance

Basic Qualifications

Experience

Education

License, Certification, Registration

Additional Requirements

Preferred Qualifications